Healthcare Provider Details

I. General information

NPI: 1124938212
Provider Name (Legal Business Name): FULL STRENGTH PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1466 NM-344
SANDIA PARK NM
87047
US

IV. Provider business mailing address

1466 NM-344
SANDIA PARK NM
87047
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-2928
  • Fax:
Mailing address:
  • Phone: 505-440-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: GAVIN LYNCH
Title or Position: DPT
Credential:
Phone: 505-440-2928